Evaluation of the Bangladesh Intersectional Support Team (IST)
Introduction and context
MSF’s Bangladesh Intersectional Support Team (IST) was established following the expansion of the Rohingya response and formalised in 2018 to support OCA, OCB and OCP in a highly regulated environment where the Government of Bangladesh expects to engage with a single MSF entity. Its mandate covers representation and access, external compliance, communications and advocacy, and shared support functions. The central challenge is that the IST evolved pragmatically beyond its original mandate without a corresponding redesign of governance, authority or sectional coordination. The result is a model that remains operationally necessary but is increasingly affected by duplicated roles, slow validation chains, unclear accountability and weakened trust.
Evaluation purpose and primary questions
Commissioned by the OCA/OCP/OCB Bangladesh inter-desk and managed by the Vienna Evaluation Unit, the evaluation was undertaken to inform the 2027 Plan of Action and budget and to identify practical options for improving or redesigning the IST. It addressed four questions:
- Is the current intersectional setup still relevant to Bangladesh’s regulatory and operational needs?
- How effectively does it deliver representation, compliance and operational support
- How efficiently are responsibilities, staff and costs organised across the IST and the three OC coordination structures?
- What governance, functional and system changes are required for a sustainable future model?
Methodology overview
This organisational and process evaluation used mixed methods, with a strong qualitative emphasis. Evidence included review of MoUs, organigrams, budgets, job descriptions, prior reviews and RIOD guidance; semi-structured interviews and group discussions with 133 participants across HQ, coordination and field levels; process mapping of key HR and supply workflows; 2022–2025 budget and FTE analysis, with selected 2026 operational data; and comparison with other multi-OC setups, especially Afghanistan. Findings were triangulated across sources and tested in a validation workshop with the three commissioning OCs. Cost results indicate patterns rather than patient-care impact or definitive causal savings.
